Healthcare Provider Details

I. General information

NPI: 1568583896
Provider Name (Legal Business Name): EASTERN ORANGE AMBULATORY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 LAUREL AVE SUITE 120
CORNWALL NY
12518
US

IV. Provider business mailing address

21 LAUREL AVE SUITE 120
CORNWALL NY
12518
US

V. Phone/Fax

Practice location:
  • Phone: 845-458-7800
  • Fax: 845-458-7878
Mailing address:
  • Phone: 845-458-7800
  • Fax: 845-458-7878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL SAYEGH
Title or Position: PRESIDENT
Credential: MD
Phone: 845-561-2920